Search

General practice is ideally suited to support patients with weight management. Hilda Mulrooney outlines some of the barriers facing nurses working in general practice and ways to overcome these Primary care is identified in national guidance as fundamental to supporting patients living with overweight and obesity. Despite this, weight is not routinely recorded and many practitioners are ambivalent about their role in this area. Barriers to addressing excess weight in primary care have been identified by patients and healthcare practitioners. This article outlines some of the barriers identified by both groups. In addition, approaches and resources which may help health professionals overcome barriers are suggested.

The coronavirus disease 2019 (COVID-19) pandemic has further emphasised the importance of recognising obesity as a health issue for adults and children, with associated increases in obesity prevalence and risk of severe illness and death from COVID-19. Obesity is highly visible and highly stigmatised. It is frequently regarded as a result of lifestyle choices and behaviours, with a focus on personal responsibility rather than as a complex, multifactorial disease with a strong genetic component. Healthcare professionals, including nurses, have an important role in supporting behaviour changes, and discussing weight with patients in neutral and respectful ways. This article outlines the effects of the COVID-19 pandemic on weight and weight-related behaviours and discusses the complexity of obesity and weight stigma. It also emphasises the importance of nurses advocating for action to address the obesogenic environment.

Food has multiple roles within individuals’ lives, with potential to bridge gaps between different groups and enhance belonging. This project sought to explore through food-related images submitted by staff and students, the themes and values identified, and explore whether taking part enhanced belonging at university. Data were collected using a questionnaire and optional interviews. The questionnaire included demographic information, food-related questions and a link to upload a food-related image. University staff and students were invited to participate by email. A total of 23 staff and 67 students completed questionnaires, and 13 interviews (4 staff and 9 student) were completed. Multiple themes were identified. These included food as an evocation of place, time and people; food in relation to tradition; the use of food to bring people together and to share, and food-related skills such as cooking and growing. Health and wider themes such as the environment and global warming were also highlighted. Demographic and study/work characteristics had little impact on either food-related beliefs and behaviours or sense of belonging at the institution. Participation increased sense of belonging in 39% of staff and 49.3% of student participants; it was not decreased in any.

Introduction: Obesity affects nearly 1 in 4 European adults increasing their risk for mortality and physical and psychological morbidity. Obesity is a chronic relapsing disease characterized by abnormal or excessive adiposity with risks to health. Medical nutrition therapy based on the latest scientific evidence should be offered to all Europeans living with obesity as part of obesity treatment interventions. Methods: A systematic review was conducted to identify the latest evidence published in the November 2018–March 2021 period and to synthesize them in the European guidelines for medical nutrition therapy in adult obesity. Results: Medical nutrition therapy should be administered by trained dietitians as part of a multidisciplinary team and should aim to achieve positive health outcomes, not solely weight changes. A diverse range of nutrition interventions are shown to be effective in the treatment of obesity and its comorbidities, and dietitians should consider all options and deliver personalized interventions. Although caloric restriction-based interventions are effective in promoting weight reduction, long-term adherence to behavioural changes may be better supported via alternative interventions based on eating patterns, food quality, and mindfulness. The Mediterranean diet, vegetarian diets, the Dietary Approaches to Stop Hypertension, portfolio diet, Nordic, and low-carbohydrate diets have all been associated with improvement in metabolic health with or without changes in body weight. In the November 2018–March 2021 period, the latest evidence published focused around intermittent fasting and meal replacements as obesity treatment options. Although the role of meal replacements is further strengthened by the new evidence, for intermittent fasting no evidence of significant advantage over and above continuous energy restriction was found. Pulses, fruit and vegetables, nuts, whole grains, and dairy foods are also important elements in the medical nutrition therapy of adult obesity. Discussion: Any nutrition intervention should be based on a detailed nutritional assessment including an assessment of personal values, preferences, and social determinants of eating habits. Dietitians are expected to design interventions that are flexible and person centred. Approaches that avoid caloric restriction or detailed eating plans (non-dieting approaches) are also recommended for improvement of quality of life and body image perceptions.

Despite substantial attention to dietary interventions on the management of obesity, there are no consensus guidelines for dietetic management of obesity in Europe. Two surveys among European dietitians have demonstrated inconsistencies in the approaches recommended within national obesity treatment guidelines. Only a small number of the guidelines include concrete actionable targets for recommended energy deficit, weight loss and weight-loss maintenance. On the other hand, dietitians frequently use 5-15% weight loss as their intervention outcome. However, they fail to monitor changes in body composition beyond weight status and to successfully monitor and prevent weight regain. Europewide guidelines on the dietary treatment of obesity are an overdue requirement for consistent dietetic practice.

Hilda Mulrooney, dietitian and Associate Professor of Nutrition at Kingston University, discusses the similarities between humans and animals when it comes to this challenging topic.

Resting energy expenditure (REE) estimates are often needed in young people and can be predicted using prediction equations based on body weight. However, these equations may perform poorly in those who are obese and overweight. The aim of this systematic review was to identify equations based on simple anthropometric and demographic variables that provide the most accurate and precise estimates of REE in healthy obese and overweight young people.Systematic searches for relevant studies in healthy obese and overweight young people aged ≤18 years were undertaken using PubMed, Scopus, Cinahl, OpenGrey and Cochrane Library (completed January 2018). Search terms included metabolism, calorimetry, obesity and prediction equation. Data extraction, study appraisal and synthesis followed PRISMA guidelines.From 390 screened titles, 13 studies met inclusion criteria. The most accurate REE predictions (least biased) were provided by Schofield equations [+0.8% (3-18 years); 0% (11-18 years); +1.1% (3-10 years)]. The most precise REE estimations (percentage of predictions ± 10% of measured) for 11-18 years were provided by Mifflin equations (62%) and, for 7-18 years, by the equations of Schmelzle (57%), Henry (56%) and Harris Benedict (54%). Precision of Schofield predictions was 43% in both age groups. No accuracy data were available for those3 years or for precision for those7 years.No single equation provided accurate and precise REE estimations in this population. Schofield equations provided the most accurate REE predictions so are useful for groups. Mifflin equations provided the most precise estimates for individuals aged 11-18 years but tended to underestimate REE.

The way that health professionals talk about conditions is crucial to patient-centred care. Hilda Mulrooney explains how obesity is a condition that is often framed in negative language that needs to be changed in order to improve healthcare quality in primary care The language and images used to describe those living with obesity are often stigmatising. They can contribute to the perception that those with obesity are responsible for their own condition. Much of the rhetoric around excess weight emphasises actions that individuals can take. This ignores the complexity of how weight is gained and retained, and the roles of genetics and environmental factors. In the UK, those advocating for obesity to be recognised as a disease suggest that this may reduce levels of weight-related stigma. The use of non-stigmatising images and people-first language are recommended to help change perceptions of blame around obesity.

Being obese and overweight affects an increasing number of adults and children in the UK. Hilda Mulrooney presents an overview of the population-based approaches to improving public health and enabling more people to lose weight Obesity is a serious condition that is highly prevalent in UK adults and children. A number of population-based approaches to improve the ‘obesogenic’ environment have been put into place while more are being proposed. Many of these approaches have the advantage of potentially altering dietary intakes without individual behaviour change, and they are taking place in a wider context that encourages physical activity and partnership working. Approaches to obesity and progress made towards targets will be discussed.

OBJECTIVES: Christian Orthodox fasting (COF), a periodical vegetarian subset of the Mediterranean diet, has been proven to exert beneficial effects on human health. Athonian fasting is a pescetarian COF variation, where red meat is strictly restricted throughout the year. Previous studies have examined the COF nutritional synthesis and health effects in general population fasters (GF) and Athonian monks (AM), separately. The aim of this study is to comparatively evaluate the characteristics and effects of this nutritional advocacy between the two populations. METHODS: The study included 43 male GFs (20-45 y of age) and 57 age-matched male AMs following COF. Dietary intake data were collected in both groups during a restrictive (RD) and a nonrestrictive (NRD) day. Nutritional, cardiometabolic, and anthropometric parameters were compared between the two cohorts. RESULTS: AM presented lower daily total caloric intake for both RD (1362.42 ± 84.52 versus 1575.47 ± 285.96 kcal, P < 0.001) and NRD (1571.55 ± 81.07 versus 2137.80 ± 470.84 kcal, P < 0.001) than GF.They also demonstrated lower body mass index (23.77 ± 3.91 versus 28.92 ± 4.50 kg/m2, P

Orthorexia Nervosa (ON) has gained increased attention in academia since 1997. However, like other "Exia" conditions, there is debate around its inclusion in the Diagnostic and Statistical Manual of Mental Disorders. This study aimed to examine the experiences of those following a diet indicative of ON in the United Kingdom. This information is essential to the development of diagnostic criteria and classification of ON. Behavioural Reasoning Theory was used to explore reasons contributing to the development of ON. Ten individuals (two males and eight females), aged 23-35 years, took part in semi-structured interviews. Inductive thematic analysis was used to analyse the results. Four themes emerged from the data-journey, social, rules/control, and ethical considerations which highlighted contributing factors to the development of ON behaviours, the impact of these behaviours on individuals' social lives, and a strive for control. These findings are the first to suggest that ON involves a more complex set of behaviours than current definitions and proposed diagnostic criteria suggest and highlight the need to consider a variety of reasons for restricted diet when developing diagnostic criteria, screening tools, and classification in the DSM. ispartof: FRONTIERS IN PSYCHOLOGY vol:12 ispartof: location:Switzerland status: published

Belonging at university is a complex and important issue which relates to student attainment but is more challenging for non-traditional students, including those with disability. This study, part of a larger project, explored differences in academic self-confidence and engagement, belonging, peer belonging and institutional acceptance in those with and without disability in two academic institutions. Quantitative data, collected using a series of statements in online questionnaires, indicated that academic self-confidence was significantly lower in those with disability, as were aspects of peer belonging. By contrast, academic engagement and institutional acceptance did not differ for most statements by disability status. Possible reasons for this, and the implications of the findings, are discussed.

For seven weeks, 37 overweight adults followed a hypocaloric diet based on Orthodox Fasting (OF). A hypocaloric, time restricted eating (TRE) plan (eating between 08:00 to 16:00 h, water fasting from 16:00 to 08:00 h) was followed by 23 Body Mass Index (BMI)-matched participants. Anthropometric, glycaemic and inflammation markers and serum lipids were assessed before and after the diets. Both OF and TRE groups demonstrated reductions in BMI (28.54 ± 5.45 vs 27.20 ± 5.10 kg/m2, p

A sense of belonging within higher education (HE) enhances educational engagement and attainment. The rapid shift to online provision has implications for reducing students’ sense of belonging at university. We have previously shown that students consider belonging in HE to be important and that their personal sense of belonging was high. We also found that sense of belonging had elements of people and place: relationships with peers and staff were influential and the physical campus facilitated social relationships. In the first lockdown, we showed that sense of belonging in both staff and students at our large widening-participation London university was reduced. In this paper, we report on a continuing project to explore the impact of sustained provision of learning online, focusing on qualitative interviews carried out with forty-three students and twenty-three staff. Both groups identified advantages and disadvantages of online provision. Advantages included flexibility and accessibility, with savings – financial and time – owing to reduced commuting. However, both groups identified a negative impact on social relationships, student motivation and engagement. Future development of blended learning should be planned, supported and structured to optimise the benefits.

Focusing on food (in)security, this paper argues that the Covid-19 pandemic has shed light on what has been so far neglected in the on-going Brexit discussions. The current pandemic has produced startling images of empty supermarket shelves, shortages of farm workers, increased use of food banks and heightened concern over the health of those at the lower end of the socio-economic scale. We argue that food insecurity was not created by the current pandemic but is a serious underlying issue in the UK, which has not been adequately considered in discussions about Brexit. In other words, the pandemic has simply highlighted the risk that Brexit will worsen food insecurity and the health of those already disadvantaged. We argue that the pandemic provides an opportunity for UK policy makers to consider the impact of food trade deals on food insecurity, one which we urge them to take.

The physical configuration of the university campus impacts upon student learning and experience, and can be used to signal institutional priorities. The extent to which campus, particularly in post 92 institutions, is designed as opposed to evolving as older buildings are repurposed or replaced is variable. Student experiences and perceptions of the campus physical space are also unclear. This study aimed to explore student perceptions using qualitative methods. Data were collected during 8 focus groups from 37 participants. The majority were young and female, with considerable ethnic diversity. Six major themes were identified, many of which did not directly relate to the physical space itself. Rather the impact upon students’ emotional experience and engagement with the institution was emphasised. ‘Belonging’ was the most common theme; indicating that the nature of the physical space on campus is not neutral, but can affect the extent to which students can form attachments with each other and academic staff. ‘Nature’ was the second most commonly mentioned theme. Green space has therapeutic potential in stress management, important given mental health concerns in young people including students. The ideal campus as described by participants would include green non-smoking spaces with an emphasis on health promotion. Opportunities to include nature on campus should be taken, and future proposals to design the campus should canvas student views.

BACKGROUND: To date, research on the dietary patterns of individuals with potential orthorexic symptoms is lacking. This cross-sectional pilot study aimed to explore the feasibility of assessing dietary patterns with psychological traits and states of individuals with possible orthorexic tendencies. METHODS: Dietary intakes of 10 individuals (two males and eight females) were assessed using 24-h recall. Mean age of participants was 28.3 years; mean body mass index was 21.2 kg m-2 . Nutrient intakes were compared with current dietary guidelines and the Eatwell Guide (Public Health England, 2016). Participants completed the ORTO-15, the Eating Attitude Test (EAT-26), the Obsessive-Compulsive Inventory-Revised edition (OCI-R), Paulhus's Spheres of Control (SoC), the Rosenberg's Self-Esteem Scale (RSES) and the Multidimensional Body-Self Relations Questionnaire (MBSRQ). RESULTS: High levels of disparity across participants' psychometric scores and 24-h recall results were observed. There was no single pattern of self-imposed dietary restrictions among participants. Described dietary practices failed to meet the guidelines for several nutrients. CONCLUSIONS: The results of this pilot study suggest that an extensive investigation of the diets of individuals with possible orthorexic tendencies in a large-scale study would contribute to the understanding of this condition. In addition, the use of multiple psychometric instruments is recommended for diagnosing orthorexic nervosa. ispartof: JOURNAL OF HUMAN NUTRITION AND DIETETICS vol:34 issue:1 pages:42-53 ispartof: location:England status: published

Belonging within higher education benefits students, staff and institutions. The Covid 19 pandemic necessitated campus closures at short notice, with teaching and assessment moving online. Understanding the impact of this upon belonging from both staff and student perspectives, and exploring whether demographic or study characteristics have an impact, is needed to inform future educational provision. A bespoke questionnaire collecting quantitative and qualitative information was administered online to staff and students at a UK university with a strong widening participation focus. A total of 208 students and 71 academic staff responded. Staff were significantly more likely than students to recognise belonging as important. Lockdown reduced feelings of belonging in both groups, and physical presence on campus was highlighted as important by both. Despite considerable diversity, student responses showed a high degree of homogeneity. Although advantages to future online teaching were identified by both staff and students, almost half of students disagreed that they would learn better if future teaching remained online. A greater proportion of staff identified teacher online presence and facilitating active learning as essential in helping students to belong, but what students consider essential in online teaching to enhance belonging is less clear from this data.

Despite substantial attention to dietary interventions on the management of obesity, there are no consensus guidelines for dietetic management of obesity in Europe. Two surveys among European dietitians have demonstrated inconsistencies in the approaches recommended within national obesity treatment guidelines. Only a small number of the guidelines include concrete actionable targets for recommended energy deficit, weight loss and weight-loss maintenance. On the other hand, dietitians frequently use 5-15% weight loss as their intervention outcome. However, they fail to monitor changes in body composition beyond weight status and to successfully monitor and prevent weight regain. Europewide guidelines on the dietary treatment of obesity are an overdue requirement for consistent dietetic practice.

‘Quality’ in education is difficult to define. What is viewed as high quality by staff, students and employers must be identified so that universities can articulate their offer. Equally, helping s...

Focusing on food (in)security, this paper argues that the Covid-19 pandemic has shed light on what has been so far neglected in the on-going Brexit discussions. The current pandemic has produced startling images of empty supermarket shelves, shortages of farm workers, increased use of food banks and heightened concern over the health of those at the lower end of the socio-economic scale due to the lockdown. We argue that food insecurity was not created by the current pandemic but is a serious underlying issue in the UK, which has not been adequately considered in discussions about Brexit. In other words, the pandemic has simply highlighted the risk that Brexit will worsen food insecurity and the health of those already disadvantaged. We argue that the pandemic provides an opportunity for UK policy makers to consider the impact of food trade deals on food insecurity, one which we urge them to take.

Pre-university (foundation or Level 3) study attracts significant student numbers annually, but approximately 10% of successful Level 3 students do not progress into their university degrees. This project aimed to identify the experiences of current and previous Level 3 students, using questionnaires and focus groups to explore differences by gender, ethnicity and intention to study. One hundred and two current and 56 previous level 3 students participated. Those who felt part of the university were significantly more likely to agree that the foundation course met their expectations. Personal support from academic staff, was highly ranked by students in all year groups, peaking in the final year. Despite considerable student diversity, the foundation year met expectations. However this was significantly lower for Black students compared with other ethnicities, which needs further exploration. Fostering ‘belonging’ to university is important for foundation year students to improve retention rates into their degree courses.

Belonging is multidimensional, personal and geographical in nature. Establishing a sense of belonging benefits students and institutions. This study sought to explore aspects of belonging from the student perspective. Data were collected using open text boxes within a questionnaire and an optional focus group. A total of 617 students participated of whom 85% completed the questionnaire. One focus group with 3 participants was held. Qualitative data highlighted personal and social aspects of belonging, and the benefits of belonging for successful study. The importance of belonging was not agreed universally but most students identified it as important, and felt that they personally belonged. Understanding what belonging means and what influences it is important to enhance student engagement and retention.

Self-assessment, whereby students are actively engaged in assessing the quality of their work, has been shown to benefit them. It is not routinely carried out in all institutions. This pilot study aimed to explore the extent to which students chose to engage with self-assessment when invited to do so, and how accurate they were when they did. A short pilot tool including qualitative and quantitative elements, was circulated to students within a school of the largest faculty of Kingston University. Students completed the self-assessment and submitted it with their completed assignments. Actual grades achieved were compared with self-assessments. Qualitative data were analysed using basic thematic analysis. The highest average marks achieved were in the group who correctly self-assessed their work. More students incorrectly self-assessed than correctly assessed their work, and almost a third of students did not engage with the activity. Those who incorrectly over-assessed their work had average marks similar to those that did not engage with the activity, significantly lower than the average marks achieved by the incorrect under-assessors and the correct self-assessment groups. Correct self-assessing students were more specific about the skills they demonstrated and the support they used for their assignments.

[][1] Hilda Mulrooney is a senior lecturer in nutrition at Kingston University, London. I recently participated in a roundtable discussion organised by Vet Record , the BVA and Mars Petcare about obesity in pets. My perspective was unusual; I have no pets and I am a dietitian who has worked in primary care and public health, primarily in the field of human obesity. But, as I was preparing for the meeting, I started thinking about the overlap between obesity in animals and people. Obesity has been a serious health concern in people for several decades, and the current statistics, in both children and adults, are depressing. Unfortunately, nowadays it is more common for people to suffer from obesity or being overweight than to be a healthy weight; healthy weight is no longer ‘normal’ in the sense of being usual for … [1]: /embed/graphic-1.gif

Working effectively within multidisciplinary\ud teams is an important employability skill\ud common in postgraduate working life, but\ud opportunities to develop this are limited in\ud many undergraduate taught programmes. The\ud projects reported here offered twelve level 5\ud undergraduate students from a range of\ud science disciplines the opportunity to work with\ud each other and staff on a specific research\ud question. This paper explores the experience\ud of cross-disciplinary research from both the\ud student and staff research partners’\ud perspectives. In particular the employability\ud skills gained from such partnership working,\ud the potential for developing and demonstrating\ud leadership skills, and the benefits and\ud disadvantages are discussed.

Transition to higher education is challenging, and may be more difficult for some groups than others. The transition from level 3 foundation year into level 4 offers the opportunity to explore student perspectives. Qualitative survey and focus group data were collected from current and previous Level 3 students, to ascertain student perceptions about induction, level of belonging, confidence about Level 4 and to identify useful support sources. Over a third of eligible Level 3 students (n=102) participated, but numbers of eligible participants from Levels 4, 5 and 6 were limited. Despite the heterogeneous nature of Level 3 students the majority of students recognised the value of the foundation year. Data suggested that Level 3 students did not identify with the university. Those who did highlighted the importance of social outlets such as clubs and societies. A major cause of dissatisfaction was perceived lack of clarity about the foundation year, including the programme, subjects and physical location of the course. This was apparent across all ethnicities, age groups and both genders. Among previous Level 3 students, personal sources of support were uniformly valued although the precise source varied by year of study. Support from academic staff, via office hours and as personal tutors, was rated as most important. Enabling academic staff to offer support to students throughout their study, and clear consistent information available throughout an ongoing transition, may help to minimise these issues.

Co-curricular activities offer an opportunity for students to develop and demonstrate employability skills. Not all students take advantage of activities on offer, while others undertake multiple activities. In this study, second and third year students from two related undergraduate degree courses who had and had not taken up co-curricular activities identified their reasons for participating or not, and completed two questionnaires exploring their motivation (Academic Motivation Scale, AMS and Motivated Strategies for Learning Questionnaire, MSLQ). First year students identified which activities they would be interested in participating in in future years, and why. Clear differences in participation between the two degree courses were seen, with significantly higher levels of intrinsic motivation among students who participated. Among those who did participate compared with those who did not, significant differences in different types of motivation were seen. Self-efficacy was also significantly higher in those who did, compared with those who did not, participate, although whether this is a cause or a consequence of participation is unclear. First year students indicated interest in a range of co-curricular activities, for personal as well as academic reasons. Further work is needed to ensure that all students understand the relevance and importance of co-curricular activities.Key words: co-curricular, real-life learning, employability skills

Greek Orthodox fasting (OF), which involves 180-200 days of fasting per year, is dictated by the Christian Orthodox religion. For the first time, this cross-sectional study examines the characteristics and the effects of OF on anthropometry, cardiometabolic markers and calcium homeostasis in Athonian monks (AMs).Daily intakes of energy, macro- and micronutrients of a day during a weekend of Nativity Fast, defined as non-restrictive day (NRD), and a weekday during Great Lent, labeled as restrictive day (RD) were recorded.The daily energy intake of 70 AM (age=38.8±9.7 years) was low during both RD and NRD (1265.9±84.5 vs 1660±81 kcal, respectively, P0.001). Paired samples t-test showed statistically significant difference between daily intakes in RD and NRD: carbohydrates (159.6±21.8 vs 294.3±23.4 g, P0.0001) and saturated fat (12.7±0.0 vs 16.4±0.0 g, P0.0001) were lower, whereas protein (89.2±1.3 vs 72.35±1.3 g, P0.001) was higher during RD. A subsample of 50 monks (age=38.7±10.6 years) formed a study cohort for cardiometabolic and calcium homeostasis assessment. Body weight (74.3±12.9 kg) and body mass index (BMI; 23.8±4.1 kg/mUnaffected by variation in lifestyle factors, the results of this unique study offers clear evidence for the health benefits of the strict Athonian OF through optimal lipid and glucose homeostasis.

Personal health & wellbeing are rated more highly in those with higher educational qualifications than those without, and good health & wellbeing are likely to impact upon student attendance and hence attainment at university. It is important to understand factors which may affect perceived health and wellbeing from a student perspective in order to develop university-specific campaigns to correct misinformation. In addition, multidisciplinary working is characteristic in the post-graduation world, but is difficult to truly replicate within formal university teaching. This project had two aims. First, through a cross-disciplinary staff-student collaboration, to explore student perceptions of health and wellbeing in Kingston University. Second, to enable students from a range of disciplines to work in active partnership with each other and with academic staff. A quiz was completed by almost 300 undergraduate students. Results from this and focus group discussions demonstrated reasonable knowledge of a range of lifestyle risk factors affecting health, but misinformation about the safety of vaccines and the importance of nutrition, activity and adequate sleep for maximising health, wellbeing and thus, potentially, university attainment. Future work is planned with Kingston University undergraduate students to address identified misconceptions. Student partners highly rated the opportunity for active learning, partnership working with staff and being part of a cross-disciplinary project team.Keywords: Partnership, cross disciplinary, health, active learning, wellbeing

Hilda Mulrooney provides an overview of the contributing factors of obesity in people with learning disabilities and discusses practical ways to approach weight management

Authentic learning opportunities replicating working environments will enhance learners’ employability and intrinsic motivation. Within most undergraduate curricula, opportunities for students to experience hands-on learning opportunities which mimic public health practice are limited. A pilot university cook and eat programme (the Cook School) was developed based upon community cook and eat programmes. The aim was to enable trained undergraduate Nutrition students to facilitate healthy eating activities to their peers, as a voluntary co-curricular activity. Two cook and eat programmes, each of five weeks duration, were offered to undergraduate students (12 participants per programme). Cooking was delivered by trained chefs and the healthy eating components were facilitated by trained undergraduate Nutrition students. Participants did not know beforehand that sessions would include nutrition information & activities in addition to cooking. Facilitators identified ‘employability’ as a key driver for their participation in this project. Their post-course evaluations suggested that key employability skills like team work, time management, communication and organisation were enhanced by involvement in the Cook School. Participants suggested that attending Cook School improved their knowledge of healthy eating. Whether this translates into improved diets long term is currently unknown. This pilot project offered undergraduate Nutrition students a unique opportunity to gain key employability skills within an authentic learning environment, working in partnership with their peers. Keywords: Authentic learning, Peer learning, Motivation, Partnership, Employability

To enhance employability opportunities, a range of co-curricular opportunities are offered to Nutrition students at Kingston University. Student uptake of these opportunities tends to be limited to a small group of highly motivated students. Using an unpaid public health project undertaken as a staff-student partnership as a case study, both the processes involved in the project and the motivation of staff and student partners are explored. Understanding what elements of motivation were involved may help to pinpoint aspects of co-curricular work to focus upon in order to increase student uptake, thus potentially enhancing graduate employability.Keywords: Intrinsic motivation, extrinsic motivation, partnership, autonomy, engagement

Estimates of energy requirements are needed in weight management and are usually determined using prediction equations. The objective of these two systematic reviews was to identify which equations based on simple anthropometric and demographic variables provide the most accurate and precise estimates of (1) resting energy expenditure (REE) and (2) total energy expenditure (TEE) in healthy obese adults.Systematic searches for relevant studies in healthy adults with body mass index (BMI) ≥25 kg m(-2) and published in English were undertaken using Cinahl, Cochrane Library, OpenGrey, PubMed and Web of Science (completed March 2014). Search terms included metabolism, calorimetry, obesity and prediction equations. Data extraction, study appraisal and synthesis followed guidelines from PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses).From 243 REE papers and 254 TEE papers identified, 21 and four studies, respectively, met the inclusion criteria. (1) The most accurate REE predictions varied with BMI subgroup: WHO (weight and height) ≥25 and ≥30 kg m(-2) ; Mifflin 30-39.9 kg m(-2) ; Henry ≥40 kg m(-2) . The most precise REE predictions were obtained using Mifflin in BMI 30-39.9 and ≥40 kg m(-2) , where approximately 75% of predictions were within 10% of measured REE. (2) No accurate or precise predictions of TEE were identified.No single prediction equation provides accurate and precise REE estimates in all obese adults. Mifflin equations are recommended in this population, although errors exceed 10% in 25% of those assessed. There is no evidence to support the use of prediction equations in estimating TEE in obesity.

Being overweight or obese increases the risk of many physical conditions. However, weight may also have an effect on mental health. Hilda Mulrooney discusses the evidence for this possibility and how health professionals can assist

Many students do not engage with reading the scientific literature, which is a core skill in undergraduate students. The learning environment has an important impact upon learning. It was postulated that taking reading out of the formal learning environment might impact upon students’ willingness to engage with the literature, and confidence in doing so. A staff-student research partnership initiative funded by Kingston University allowed this hypothesis to be tested. Three Tea Club sessions, informal drop-in reading sessions were offered in a student-owned space within the Students’ Union. Refreshments were supplied, aiming for a ‘coffee house’ feel. Although the numbers of students who engaged with the Tea Club were small, evaluations were positive. In particular students valued the opportunity for peer learning. However the chosen environment was too noisy. Future sessions will be offered within a different, less noisy environment with facilities for refreshments, and will be offered throughout the academic year to facilitate student engagement.Keywords: Learning environment, peer support, extracurricular, scientific reading

Student expectations with regard to what comprises quality in higher education can impact upon their learning, engagement and overall satisfaction. Perceptions of quality are not always clearly articulated and may vary by gender, ethnicity and year of study. In this study, undergraduate students completed a questionnaire indicating whether they agreed, disagreed or were unsure about 15 statements related to quality in higher education. A total of 340 students across four year groups participated (Levels 3-6), with more female than male participants and a range of ethnicities represented. There was broad unanimity in the recognition of the importance of both teaching and learning and relationships with academic staff in defining quality. Overall, there were low levels of satisfaction with the amount of contact with academic staff and uncertainty about whether students thought they were getting a high quality education. Some differences in relation to support services were seen in different ethnic groups, and more males than females were satisfied with support services although this varied by year group, and student numbers were small. These results suggest the importance of clearly articulating what is available in terms of support (academic, pastoral, study and health) to all students. The teaching and learning experience, and relationships with academic staff are clearly important and given the uncertainty about overall perceptions of quality, these aspects need to be highlighted to students so that they understand the value of what they are receiving.Keywords: quality, perceptions, relationships, feedback, teaching & learning